THE PROBLEM OF SOMATIZATION IN FAMILY-PRACTICE

Patients with somatization disorder, in the full-blown or subsyndromal form, are high users of health care and often receive expensive, unne cessary tests and treatments. Their multiple somatic complaints do not have a biomedical basis but, instead, reflect underlying emotional co nflicts that the patient is unable to face. Treatment of these patient s is difficult, with no approach showing a good cure rate. However, if the underlying psychosocial etiology is understood and modest goals a re set, much can be done to limit the problem and reduce symptoms. Man agement includes setting clear limits on the patient's access to the p hysician, while maintaining an empathetic and supportive doctor-patien t relationship. Behavioral cognitive psychotherapy and short-term inte nsive psychotherapy may help the patient understand the underlying con flicts and thereby reduce the symptoms.